Biley Vihar, Daudnagar, Distt.

-Aurangabad (Bihar)-824113
(A Senior Secondary School Affiliated to C.B.S.E., Delhi)
School No. : 65147 Aff. No. : 330154
TRANSFER CERTIFICATE
SI. No. 504}
Affiliation No ................................................................. School Code ........................................................... .
Book No ............................................... SI.No .................................................. Admission No ............................. .
1. Name of the Student:- ............................................................................................................................................... .

2. Mother's Name :- ........................................................................................................................ ,,.......................... .

3. Father's/ Guardian's Name :- .................................................................................................................... .

4. Date of Birth (in Christian Era) according to Admission & Withdrawal Register.

(In figures) .............................................. (in words) .................................................................................. .

5. Proof for Date of Birth submitted at the time of admission ....................................................................... .

6. Nationalit·y .................................................................................................................................................. .

7. Whether the candidate belongs to Schedule Caste or Schedule Tribe or OBC ....................................... .

............................... A ............................................•......•.....•....•...•••...• , ............................................................ .

8. Date of first admission in the school with class ...................................................................................... ..

9. Class in which the pupil last studied (in figures) ......................... (in words) ........................................... ..

10. School I Board Annual Examination last taken with result ...................................................................... ..

11. Whether failed, if so once I twice in the same class ............................................................................... ..

12. Subject Studied : 1............................................. 2 .......................................... 3............................................. .

4 ........................................ ,.... , 5........................................... .

13. Whether qualified for promotion to higher class ....................................................................................... .

if so, to which class (in fig.) ........................ (in words) ..... ...................................................................... .

14. Total No. of working days in the academic session ................................................................................. .

, 15. Total No. presence in the academic session .......................................................................................... ..

16. Month upto which the pupil has paid School dues ...... :............................................................................ .

17. Any fee concession availed of, if so, the nature of such concession ........................................................ .

18. Whether NCC Cadet/ Boy Scout/ Girl Guide (details may be given) ..................................................... .

19. Whether school is under Govt. / Minority / Independent Category ........................................................... .

20. Games played on extra curricular activities in which the pupil usually took part (mention achievement

level therein) ............................................................................................................................................................ .

.......................................................... ............................................................................................................................... , ................... .

21. Date of application for Certificate ...................................................... ., ...................................................... ..

22. Date on which pupils name was struck off the rolls of the school ............................................................ ..

23.. Date of issue of Certificate ................................................................................. ,. ································"········ ..········

24. Any other remarks ............................................................................................................................................. ..

I hereby declare that the above information including Name of the Candidate, Father's Name, Mother's

Name and Date of Birth furnished above is correct as per school records.